Implementation of the American College of Surgeons Geriatric Surgery Verification Program at the James Cancer Hospital
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 4,000
- 试验地点
- 1
研究概览
简要总结
This study examines how the American College of Surgeons Geriatric Surgery Verification Program, also called the ACS GSV Program, is implemented at the James Cancer Hospital. The program is designed to improve surgical care for adults age 65 and older by helping care teams identify and address age-related needs before, during, and after surgery.
Older adults with cancer may have concerns related to physical function, memory or thinking, medications, social support, and goals of care. If these needs are not recognized, patients may be at higher risk for complications, longer hospital stays, readmission, or discharge to a facility instead of home.
The ACS GSV Program includes standards for geriatric surgery leadership, goals-of-care discussions, screening for age-related vulnerabilities, care plans for identified needs, age-friendly perioperative care, and regular review of surgical outcomes. This study will evaluate how well these standards are adopted across surgical oncology services and whether implementation is associated with better outcomes, such as shorter hospital stays, fewer complications, fewer readmissions, and improved discharge outcomes.
The results may help improve surgical care workflows for older adults undergoing cancer surgery.
详细描述
PRIMARY OBJECTIVES:
I. To determine adoption, fidelity, sustainability, acceptability, and appropriateness/feasibility of implementing the American College of Surgeons Geriatric Surgery Verification (ACS GSV) Program at the James Cancer Hospital.
II. To compare clinical outcomes before and after ACS GSV implementation at the James Cancer Hospital.
SECONDARY OBJECTIVES:
I. To estimate the costs and incremental cost effectiveness of implementing each of the six ACS GSV standards.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Patient records for adults aged 65 years or older
- •Patient records with a surgical encounter or preoperative evaluation within participating James Cancer Hospital surgical oncology services during the rollout period
- •Patient records with data available in institutional electronic health record or institutional data systems
- •Clinical staff age 18 years or older who are employed or credentialed at The Ohio State University Wexner Medical Center and work within clinical areas affected by ACS Geriatric Surgery Verification implementation
排除标准
- •Patient records for encounters occurring only at outside institutions or non-James hospitals within the enterprise
- •Patient records missing all primary outcome fields after data quality checks
- •Clinical staff who are trainees, including medical students, physician assistant students, nursing students, resident physicians, or fellows
- •Clinical staff whose employment, visa, or institutional status would make participation sensitive under institutional policy, if applicable
研究组 & 干预措施
Group 1 (months 3-6 ACS GSV)
Participants complete the Serious Illness Conversation Program (SICP) workshop over two months (months 1-2). Participants then implement the ACS GSV program into surgical services over four months (months 3-6) followed by a transition period over 1 month (month 7) and continued maintenance implementation of the ACS GSV program over 9 months (months 8-16).
干预措施: Serious Illness Conversation Program training (Behavioral)
Group 1 (months 3-6 ACS GSV)
Participants complete the Serious Illness Conversation Program (SICP) workshop over two months (months 1-2). Participants then implement the ACS GSV program into surgical services over four months (months 3-6) followed by a transition period over 1 month (month 7) and continued maintenance implementation of the ACS GSV program over 9 months (months 8-16).
干预措施: ACS Geriatric Surgery Verification Program Implementation (Other)
Group 2 (months 8-11 ACS GSV)
Participants complete the SICP workshop over two months (months 6-7). Participants then implement the ACS GSV program into surgical services over four months (months 8-11) followed by a transition period over 1 month (month 12) and continued maintenance implementation of the ACS GSV program over 4 months (months 13-16).
干预措施: Serious Illness Conversation Program training (Behavioral)
Group 2 (months 8-11 ACS GSV)
Participants complete the SICP workshop over two months (months 6-7). Participants then implement the ACS GSV program into surgical services over four months (months 8-11) followed by a transition period over 1 month (month 12) and continued maintenance implementation of the ACS GSV program over 4 months (months 13-16).
干预措施: ACS Geriatric Surgery Verification Program Implementation (Other)
Group 3 (months 13-16 ACS GSV)
Participants complete the SICP workshop over two months (months 11-12). Participants then implement the ACS GSV program into surgical services over four months (months 13-16).
干预措施: ACS Geriatric Surgery Verification Program Implementation (Other)
Group 3 (months 13-16 ACS GSV)
Participants complete the SICP workshop over two months (months 11-12). Participants then implement the ACS GSV program into surgical services over four months (months 13-16).
干预措施: Serious Illness Conversation Program training (Behavioral)
研究者
Samilia Obeng-Gyasi
Principal Investigator
Ohio State University Comprehensive Cancer Center